Almost everyone knows the feeling. A heavy meal, a fizzy drink, a stressful week, and your stomach lets you know about it with burning, bloating or a gnawing discomfort that will not quite go away.
Most of the time this is ordinary and it passes. The trouble is that a small number of stomach problems that need attention start out feeling exactly the same, so it helps to know where the line sits.
Indigestion and what it really means
Indigestion, which doctors call dyspepsia, is the general word for discomfort in the upper belly. It can feel like burning, fullness after only a little food, or a dull ache below the ribs. It is a description of a feeling, not a diagnosis in itself.
Common triggers are large meals, fatty or fried food, spicy food, alcohol, coffee, smoking and eating late at night. Stress and anxiety genuinely make it worse, because the gut and the mind are closely linked.
Reflux and that burning behind the chest
When the burning rises up towards the throat, especially after eating or when you lie down, that is usually acid reflux. This is acid from the stomach washing back up into the gullet, the tube that carries food down from your mouth.
Reflux is very common and often improves with simple changes. Eating smaller meals, not lying down for a few hours after eating, raising the head of the bed, losing extra weight and cutting back on alcohol and late night snacks all help. A class of medicines that reduce stomach acid can settle it, and a pharmacist or doctor can advise you.
Bloating and trapped wind
Bloating is the feeling of being swollen or tight in the belly, often with wind. It usually comes from the normal gas that food produces as it is digested, and certain foods make more of it, including beans, onions, fizzy drinks and very fatty meals.
For many people bloating is linked to the way the gut squeezes and reacts to food rather than to any disease. Eating slowly, chewing well, keeping regular meals and staying active all reduce it. Bloating that is new, constant and does not settle deserves a check, particularly in women, and we come back to that below.
Gastritis, the inflamed stomach lining
Gastritis means inflammation of the lining of the stomach. It can cause a gnawing or burning pain, nausea and a feeling of fullness. Common causes are a germ called Helicobacter pylori, heavy use of certain painkillers known as anti inflammatories, and alcohol.
Helicobacter pylori is worth knowing about because it is common, it can be found with a simple test, and it can be cleared with a course of treatment. If gastritis keeps returning, testing for it is often the sensible next step, and our laboratory is on site.
Simple things that help most stomachs
Before any test, ordinary habits do a great deal of the work. Eat smaller and more regular meals rather than one large one. Slow down at the table. Cut back on alcohol, very fatty food and late eating. If you smoke, stopping helps the whole digestive tract. Keep a few days of notes on what you ate and how you felt, because patterns often reveal the trigger.
When a doctor thinks about endoscopy
An endoscopy is a test where a thin flexible tube with a camera is passed through the mouth to look directly at the gullet, stomach and the first part of the small bowel. It lets the doctor see the lining, take small samples and check for ulcers, inflammation and other problems.
It is not needed for everyday indigestion. A doctor is more likely to suggest it when there are warning features, such as difficulty or pain on swallowing, ongoing vomiting, unintended weight loss, a low blood count from iron loss, a family history of stomach cancer, or symptoms that started for the first time later in life. Persistent symptoms that do not settle with treatment are another reason to look.
Endoscopy is available here, so if it is recommended it can be arranged without sending you elsewhere.
What to do next
If your stomach trouble is occasional and tied to what you eat, start with the simple changes above and give them a few weeks. If symptoms keep coming back, are getting worse, or come with any of the warning signs, book a consultation. A short conversation, an examination and, where needed, a test will usually sort out what is going on and put your mind at rest.
Stomach trouble that will not settle? Get it looked at at Newtown.
Consultation, laboratory testing, ultrasound and endoscopy are all available under one roof at 55 Woodford Street, Port of Spain, so a stubborn stomach problem can be assessed and investigated in one place. Book a consultation and our doctors will decide whether you need tests. Our Accident and Emergency department is open 24 hours if you have severe pain, vomiting blood or black stools.
This article is for general education only and is not a substitute for personal medical advice, diagnosis or treatment. Always consult a qualified healthcare provider about your own health. If you believe you have a medical emergency, call or visit our 24-hour Accident and Emergency department immediately.